When we started our work on diversity and inclusion in 2016, I asked myself how can I – as a middle-class, middle-aged, well-educated, heterosexual white female – lead this work? In service of my role as organisational development lead within The King’s Fund, and my personal belief in what’s right, I couldn’t not take on the challenge. Since then, mostly it has felt messy, uncomfortable and risky, and I can feel overwhelmed and lost in it. Why? There are many complexities in the learning and change involved.
I have limited personal experience of, for example, exclusion and discrimination. Arguably some, as an albeit privileged female, but far from the constant micro-aggressions and barriers experienced by people in under-represented groups, such as those described by my colleague in the second blog in this series. I was unsure where to find resources to gain knowledge and insight and came to understand the answer does not lie in burdening under-represented colleagues with my education.
In starting conversations, I was uncertain of language and afraid of causing offence. I was ashamed of my own prejudices, of how our white, male dominant society plays out here in the Fund and how this affects differences in the experiences of colleagues. Growing understanding and becoming a little less ‘blind’ brings with it dilemmas in judging when it’s useful to openly confront when I notice my own and others’ part in, for example, exclusion and homogenous thinking.
I was all the time aware of the challenge of truly engaging my colleagues’ minds and hearts; the political and power minefield of achieving the support of our organisation’s leaders, of persuading our well-represented groups that we have a part to play in it, and of convincing under-represented groups that there’s a genuine intention and commitment to achieve change.
There are many more examples of complexity in this work. And what if I were a young, well-educated, black, Asian or minority ethnic (BAME) woman driven to lead these changes, more equipped from experience than I? I can’t imagine how amplified the challenges might be for her, amplified times again should she also ‘have an accent’, and yet again should she also be gay, or have a disability…
Perhaps I’m being the best leader I can be, in being fully alive to my not knowing, and to the complexity of this work. As Hong-Anh points out in her blog, our context is a society recognised as systemically racist and where ‘other-isms’ persist. To ‘not know’ is counter intuitive in an organisation whose reputation is built on knowledge, but I find myself all the more listening, discovering and unlearning as I progress this work with a growing and diverse group* of interested colleagues.
And I’m becoming all the more passionate about us becoming an organisation that lives diversity – that values, seeks out and includes people who have different backgrounds, experiences, perspectives, preferences and ideas. In increasing our workforce diversity and the diversity of people with whom we work, we also need to build our capability in working with difference. This can mean many things: letting go of being the expert, valuing feelings and experience as highly as knowledge, being humble enough to recognise our own part in prejudice and societal norms, inviting and listening to truths, and being curious and open to challenge.
It’s a different kind of conversation, and our starting point is in the group of colleagues engaged in this work. We’re creating space in regular discussion groups to explore different aspects of diversity, for example, intersectionality, advantage blindness and our experiences of inclusion and exclusion in our work. My belief is that, as a result, I and others in this group are shifting our own mindsets, habits and behaviours, and through our interactions with others, we’ll contribute to achieving a culture change. We’ll then also be better equipped to work on behalf of and with people in the health and care system to challenge its racism and other forms of discrimination, and to support its diversity.
The range of activities specifically designed to impact diversity and inclusion are inter-dependent with other organisational development work. For example, we need to be able to have difficult, uncomfortable conversations, to call out behaviour that isn’t aligned with our values, to learn what ease and agreement might be telling us about power and who or what is privileged in the organisation, and to develop leadership through its breadth and depth. In other words, the work needed to achieve our ambitions for diversity and inclusion is as much about how we work as what we do; it’s multi-faceted and interconnected. It will take personal and collective commitment and long-term, relentless attention.
The work belongs to everyone, but in particular leaders who influence the organisation’s culture. Any organisational development leads reading this will know that it’s often our work to facilitate and enable this; to thread it through our everyday interactions and interventions, to ensure it features in operating plans and strategies and to grow commitment and ambition.
We have a long way to go in The King’s Fund, but have made steady progress since 2016, when we had our first breakthrough conversation. Perhaps I can take some credit along with the courageous support, challenge and, increasingly, leadership of the group engaged alongside me in this work. I also look like, speak like, am like the power in the organisation – the advantage of advantage at work that allows me to influence the current leaders of the organisation. This I do know now, and I also know that this leadership work is hard – and many times harder for those involved who do not have the benefit of societal advantages. And just when the going gets really tough, there’s great satisfaction, discovery and joy to be found in this work – as the learning and change start to make a difference.
- * Relatively diverse, given the under-representation at the Fund.
When I was MD of Wrighthington, Wigan and Leigh FT (2010 - 2016) we reduced harm to patients by transforming Culture of bullying to kind, caring,compassionate learning Culture and staff and patient engagement Culture. We appointed diverse medical leaders and we implemented good governance and Accountability.
We empowerd staff to speakup. 70 staff raised concerns with Executive Directors. We created patient safety Culture and staff happiness Culture.
The Trust received 45 awards and 90% reduction in harm.
To change the Culture leaders must understand the Culture. There has to be Accountability for all leaders.
Today in NHS We have management Culture and not leadership Culture.
Leader leads with honesty, sincerity, integrity and courage. Fairness, inclusion, truth, justice, unity means a lot to leader.
Without Accountability and good governance we will not be able transform the Culture.
In a Culture of bullying, club Culture staff do not speakup and patients suffer.
To change the Culture, we must change the leaders. Without Accountability and good governance, we will not make #NHS safer or better.